Auditor, Provider Enrollment and Credentialing

Denver Health
tuition reimbursement, retirement plan
United States, Colorado, Denver
601 Broadway (Show on map)
Jan 22, 2025
We are recruiting for a motivated Auditor, Provider Enrollment and Credentialing to join our team! We are here for life's journey. Where is your life journey taking you? Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all: Humanity in action, Triumph in hardship, Transformation in health. Department Medical Staff Services and Provider Enrollment Job Summary Under minimal supervision, ensures credentialing and privileging activities of the Medical Staff Services and Provider Enrollment Teams comply with requirements of regulatory and accrediting agencies including the Centers for Medicare/Medicaid Services, the Joint Commission, and the National Committee for Quality Assurance, federal and state laws and delegated credentialing agreements independently. Essential Functions: Audits credentials files and verifies information entered in information systems (50%) Maintains and analyzes quality data, identifies trends, and recommends corrective actions (10%) Coordinates external audit engagements and responding to complex inquiries (5%) Prepares and submits material for external audits and Corrective Action Plans (5%) Works with Coordinators in Medical Staff and Provider Enrollment to ensure audit results are identified, shared and monitored for continued compliance (10%) Works with Departments/Divisions to maintain monthly rosters and to ensure all data elements are captured appropriately (15%) Assist in the maintenance of information flowing between MD Staff and EPIC to be correct (5%) Education: High School Diploma or GED Graduation from High School or equivalent required Required Work Experience: 4-6 years Five years of relevant experience in Medical Staff credentialing & privileging and/or Provider Enrollment Required Licenses: Knowledge, Skills and Abilities: MD Staff knowledge is preferred Computer proficiency in Windows, Microsoft Office, and Internet Knowledge of TJC, NCQA and CMS credentialing and enrollment standards Ability to handle multiple tasks, simultaneously Ability to interpret and apply policies and procedures Ability to communicate in a professional and positive manner Must be able to work independently and meet schedules and deadlines Shift Days (United States of America) Work Type Regular Salary $28.99 - $42.16 / hr Benefits Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans Free RTD EcoPass (public transportation) On-site employee fitness center and wellness classes Childcare discount programs & exclusive perks on large brands, travel, and more Tuition reimbursement & assistance Education & development opportunities including career pathways and coaching Professional clinical advancement program & shared governance Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer Our Values Respect Belonging Accountability Transparency All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver's 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation. As Colorado's primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year. Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer. We strongly support diversity in the workforce and Denver Health is an equal opportunity employer (EOE). Denver Health values the unique ideas, talents and contributions reflective of the needs of our community. For more about our commitment to diversity visit: https://www.denverhealth.org/for-professionals/careers/diversity-and-inclusion Applicants will be considered until the position is filled.